Abstract
PurposeThe aim of this study was to analyze prognostic factors for ovarian metastases (OM) in colorectal cancer (CRC) using data from a Chinese center. In addition, the study aimed at developing a new clinical scoring system for prognosis of OM of CRC patients after surgery.Patients and methodsData of CRC patients with OM were collected from a single Chinese institution (n = 67). Kaplan-Meier analysis was used to evaluate cumulative survival of patients. Factors associated with prognosis of overall survival (OS) were explored using Cox’s proportional hazard regression models. A scoring system to determine effectiveness of prognosis was developed.ResultsMedian OS values for patients with or without surgery were 22 and 7 months, respectively.Size of OM, number of OM, peritoneal metastasis (PM), Peritoneal cancer index (PCI), and completeness of cytoreduction (CC) were associated with OS of patients through univariate analysis. Multivariate analysis using a Cox regression model showed that only CC was an independent predictor for OS. Three variables (the size of OM >15cm, PCI ≥ 10, and carcinoembryonic antigen (CEA) >30 ng/mL) assigned one point each were used to develop a risk score. The resulting score was used for prognosis of OS.ConclusionSurgical treatment of metastatic sites is effective and safe for CRC patients with OM. CC-0 is recommended for improved prognosis. The scoring system developed in this study is effective for prediction of OS of patients after surgery.
Highlights
Colorectal cancer (CRC) is the third most common cancer type in both males and females and the second leading cause of cancer-related death worldwide [1, 2]
To the best of our knowledge, recurrence, and distant metastasis still exist after detection, and currently, few studies report on the risk stratification and selection of patients who may benefit from surgical oophorectomy
Inclusion and exclusion criteria Patients were enrolled into the study according to the following criteria: (1) diagnosis of CRC with synchronous or metachronous ovarian metastasis (OM); (2) Eastern Cooperative Group (ECOG) performance status 0 or 1, and no extraabdominal disease on radiological investigation; and (3) extent of OM evaluated either via contrast-enhanced computed tomography (CT) or magnetic resonance imaging of the ovaries, and treatment was discussed by the multidisciplinary cancer treatment team (MDT)
Summary
Colorectal cancer (CRC) is the third most common cancer type in both males and females and the second leading cause of cancer-related death worldwide [1, 2]. Previous studies report that the incidence of ovarian metastasis (OM) in female CRC and in female metastatic CRC are 1.6 (%) ~ 7.2 (%) and 5–10 (%), respectively [3,4,5,6]. CRS has revolutionized treatment of OM in CRC patients [16]. Chen et al World Journal of Surgical Oncology (2021) 19:220 survival benefits (median OS of 36 to 43 months) after undergoing CRS compared with systemic chemotherapy [3]. To the best of our knowledge, recurrence, and distant metastasis still exist after detection, and currently, few studies report on the risk stratification and selection of patients who may benefit from surgical oophorectomy. It is necessary to develop a clinical criterion for selecting patients to undergo surgical oophorectomy
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